Column: Doctor: Prescription drug bills raise privacy concerns

Thursday, June 12, 2014

By BRAD KLEIN

Times Guest Columnist

As a practicing physician in suburban Philadelphia, I see firsthand how prescription drug abuse has become a great concern in Pennsylvania and across the country. Pharmacy robberies have spread to communities of all sizes and “doctor shopping” – seeking multiple doctors to write prescriptions that aren’t medically necessary – is becoming all too common.

Fighting this epidemic is a laudable goal. The Pennsylvania Legislature is very close to creating a system that monitors what it considers to be the painkilling drugs most likely to be abused.

Pennsylvania’s Controlled Substance, Drug, Device and Cosmetic Act categorizes all controlled substances in five drug schedules. Schedule I drugs have a high potential for dependency, while Schedule V drugs have the lowest potential for abuse.

The state Senate passed Senate Bill 1180 in May while the House passed House Bill 1694 last October. Both intend to reduce abuse by creating a Prescription Drug Monitoring Program database so doctors can determine whether patients are in fact “doctor shopping” or are legitimately in need of the medicine.

As our lawmakers tackle the prescription drug abuse epidemic, an increasing number of physicians and patient advocate groups are pushing to ensure the solution doesn’t go too far and create unintended consequences for certain patients for whom timely access to life-saving medication is paramount.

For example, even though no less an authority than the U.S. Drug Enforcement Agency rates Schedule V drugs as having the lowest potential for dependency, S.B. 1180 still includes them in the monitoring program. These drugs are generally used for antidiarrheal, antitussive, and analgesic purposes, but also include medications such as anti-epilepsy drugs.

Let’s not paint all prescription drugs in a negative light simply because a minority of these medications are more likely than others to lead to addiction. We must be careful not to infringe on the privacy rights of patients suffering from chronic conditions such as epilepsy by placing their names and their medications in the same database alongside more addictive medications. And we shouldn’t create additional administrative and bureaucratic hurdles for physicians that could impede urgent access to medications needed to control seizures. Making sure patients and their treatments aren’t affected by legislative action is critical.

The executive directors from both Pennsylvania affiliates for the Epilepsy Foundation have already notified legislators that including Schedule V medications such as anti-epilepsy drugs in the monitoring program will endanger the health and privacy of epilepsy patients.

What if an epilepsy patient wants to keep his or her condition discreet? Who has access to the database? Could the information leak to employers or other people who have no business knowing the medical history of a person treating a chronic condition?

Physicians – in consultation with their patient – are the best experts to determine what course of treatment should be followed. More hurdles for doctors treating epileptic patients could result in a delay for those patients in accessing their medications that potentially creates additional suffering.

We all understand the need to address the rising prescription drug abuse epidemic in Pennsylvania. However, we can’t afford to do it with a broad-brush approach that comes at the expense of those who desperately need specific types of medications for the appropriate treatment of conditions such as epilepsy.

Exempting anti-epilepsy drugs from the legislation is a simple way to ensure access and privacy while still addressing prescription drug abuse via the monitoring program. According to the Alliance of States with Prescription Monitoring Programs, at least 18 states have recognized that PDMPs should exempt Schedule V controlled substances from monitoring requirements.

State Rep. William Adolph, R-165 of Springfield, was responsible for an amendment in H.B. 1694 that exempts certain Schedule V non-narcotics, such as anti-epilepsy drugs, from the definition of “controlled substance.” He continues to fight to ensure that policy is included in final legislation.

I sincerely ask the Legislature to follow Rep. Adolph’s recommendation.